| NPI | 1205107828 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171400000X |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: MT 5952) |
| 225700000X Massage Therapist (Licence: OR 18071) | |
| Enumeration Date | 2012-01-13 |
| Last Update Date | 2024-04-08 |